| NPI | 1073741369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 52281) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 076982) |
| 207R00000X Internal Medicine (Licence: NC 157930) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2023-02-28 |