| NPI | 1821021791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01066503A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036056635) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-12-27 |