| NPI | 1205487824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01089811A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.074185) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2023-08-30 |