| NPI | 1841284171 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01058806A) | 
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01058806) | 
| Enumeration Date | 2005-09-01 | 
| Last Update Date | 2011-03-02 |