| NPI | 1124086343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2022-0068) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01040532A) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2023-07-10 |