| NPI | 1003073404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01065481A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 11013872a) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2024-04-04 |