| NPI | 1932363108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01068452A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2012-01547) |
| 207Q00000X Family Medicine (Licence: NC 2012-01547) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2018-12-18 |