| NPI | 1437370806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: IN 01075102A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01075102A) |
| 208000000X Pediatrics (Licence: IN 01075102A) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-03-16 |