| NPI | 1841507605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01081516A) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A83402) | 
| 207QA0401X Family Medicine, Addiction Medicine (Licence: IN 01081516A) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A83402) | |
| Enumeration Date | 2010-08-31 | 
| Last Update Date | 2021-03-17 |