| NPI | 1376506915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01023363) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01023363) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2007-11-15 |