| NPI | 1861426694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: IN 01075456A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-104711) |
| 207Q00000X Family Medicine (Licence: IN 01075456A) | |
| 207QS0010X Family Medicine Sports Medicine (Licence: IL 036104711) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-07-21 |