| NPI | 1942525027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01072895A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY IP1252) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2022-06-24 |