| NPI | 1922294479 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IN 01055708A) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01055708A) | 
| Enumeration Date | 2007-09-19 | 
| Last Update Date | 2017-01-17 |