| NPI | 1215908959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-21227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 017275) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2022-07-25 |