| NPI | 1821250846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 11014492A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 8006130-1205) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2026-02-24 |