| NPI | 1205401601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 70614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351047920) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2024-08-07 |