| NPI | 1811564628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01088231A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11021674A) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2022-12-12 |