| NPI | 1588621890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01058153a) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01058153A) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2022-08-04 |