| NPI | 1881895233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01064429A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116017383) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-09-14 |