| NPI | 1881674703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01059997A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301084790) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-12-08 |