NPI | 1669484333 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01069552A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01049047) |
207Q00000X Family Medicine (Licence: IN 01069552A) | |
Enumeration Date | 2006-08-12 |
Last Update Date | 2014-11-18 |