| NPI | 1023173077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01071492A) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD432725) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: MO 2008013228) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-02-10 |