| NPI | 1801470984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02007857A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 05-51049) |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2025-05-19 |