| NPI | 1033193024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 29750) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01042750A) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2023-01-17 |