| NPI | 1932588563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01079775A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 56393) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2021-07-21 |