| NPI | 1144664376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 54660) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.43284) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2024-11-16 |