| NPI | 1225200462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY TP138) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 99033592A) |
| 207R00000X Internal Medicine (Licence: TN BU6476407R519) | |
| 207R00000X Internal Medicine (Licence: TN MD0000043766) | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2010-02-11 |