| NPI | 1528470853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083S0010X Preventive Medicine, Sports Medicine (Licence: SD 14276) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02004796A) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: IN 02004796A) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: SD 14276) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2023-09-20 |