| NPI | 1285890426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: IN 01077873A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101251011) |
| 208D00000X General Practice (Licence: SC 81697) | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2022-10-15 |