| NPI | 1134548258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2022-01531) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 56118) |
| 207R00000X Internal Medicine (Licence: MS 28157) | |
| 207R00000X Internal Medicine (Licence: AR E-14007) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2022-10-11 |