| NPI | 1922685114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: IN 01087925A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01087925A) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-04-09 |