| NPI | 1790206977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02005469a) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11019647A) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2020-10-15 |