| NPI | 1043201700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01056444) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: IN 01056444A) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2018-03-17 |