| NPI | 1285838433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01065926A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01065926A) |
| 208D00000X General Practice (Licence: IN 01065926A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301090292) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2018-05-22 |