| NPI | 1245467281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01068538A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01068538A) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: KS 04-35771) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2023-11-03 |