| NPI | 1730153586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 23359) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN IN01033830) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2024-08-16 |