| NPI | 1942277876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01086774A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301047052) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2022-06-01 |