| NPI | 1215340286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 24158) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 24158) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MS 24158) | |
| Enumeration Date | 2014-06-08 |
| Last Update Date | 2026-01-01 |