| NPI | 1912145731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: IN 02003560A) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: IN 02003560A) |
| 207QA0505X Family Medicine Adult Medicine (Licence: IN 02003560A) | |
| 207R00000X Internal Medicine (Licence: IN 02003560A) | |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: IN 02003560A) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: IN 02003560A) | |
| 2083S0010X Preventive Medicine Sports Medicine (Licence: IN 02003560A) | |
| 208D00000X General Practice (Licence: IN 02003560A) | |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2022-10-24 |