| NPI | 1689194086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01084067A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL40879) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2021-03-24 |