| NPI | 1225615933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 6295) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02007815A) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2025-06-23 |