| NPI | 1821037128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01077850A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME92778) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-01-19 |