| NPI | 1902420789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 11021038A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 02006478A) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2023-08-30 |