| NPI | 1871577965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01043965A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01043965) |
| 207Q00000X Family Medicine (Licence: MI 4301510395) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2024-03-05 |