| NPI | 1063850576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01076512A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01076512A) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2025-09-05 |