| NPI | 1740710482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 02006495A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 5101023445) |
| 207Q00000X Family Medicine (Licence: IN 11020824A) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2024-12-16 |