| NPI | 1104356740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01081644A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01081644A) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: IN 01081644A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2024-04-04 |