| NPI | 1508191248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: TN 45249) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: HI MD-12998) |
| 208D00000X General Practice (Licence: TN 45249) | |
| 208D00000X General Practice (Licence: HI 12998) | |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2020-09-09 |