| NPI | 1750762506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 11018414A) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 11018414A) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2021-07-07 |