| NPI | 1437239969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01045273) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01045273) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-09-16 |