| NPI | 1104867043 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IN 01036319A) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01036319A) | 
| Enumeration Date | 2006-06-10 | 
| Last Update Date | 2025-09-15 |