| NPI | 1760745582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02004522A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11016709A) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2021-06-04 |