| NPI | 1124596549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101028343) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26027588A) |
| 207L00000X Anesthesiology (Licence: MI 5151015126) | |
| Enumeration Date | 2018-11-03 |
| Last Update Date | 2024-12-31 |