| NPI | 1164985180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01094635A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301506895) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2024-08-14 |