| NPI | 1508973165 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IN 36000176A)  | 
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: IN 36000176A)  | 
| Enumeration Date | 2006-08-23 | 
| Last Update Date | 2025-09-11 |