| NPI | 1215424981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 4385) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 30978) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2024-03-22 |