| NPI | 1295232643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 02006385A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11019906A) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2022-08-19 |