| NPI | 1467435974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: IN 01046234A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 40325) |
| 207Q00000X Family Medicine (Licence: IN 01046234A) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2021-07-21 |