NPI | 1770069718 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01088629A) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 01088629A) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 32710) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 309901) | |
Enumeration Date | 2018-07-12 |
Last Update Date | 2022-10-05 |