| NPI | 1982021044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: TN 59978) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: TN 59978) |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: VA 0101270081) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: VA 0101270081) | |
| 208D00000X General Practice (Licence: TN 59978) | |
| 208D00000X General Practice (Licence: VA 0101270081) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2025-04-22 |