| NPI | 1881956001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01073418A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-38281) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2023-03-07 |