| NPI | 1972613131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01043939A) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: IN 01043939A) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-08-18 |