| NPI | 1760463566 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208D00000X General Practice (Licence: IN 01042881)  | 
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: IN 01042881)  | 
| 207P00000X Emergency Medicine (Licence: IN 01042881A)  | |
| Enumeration Date | 2005-11-08 | 
| Last Update Date | 2020-04-29 |