| NPI | 1710398359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01082175A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301105211) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2023-04-28 |