| NPI | 1740403765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01066732A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11013064A) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2026-06-03 |