| NPI | 1245387737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 9440) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR R-4704) |
| 207R00000X Internal Medicine (Licence: MS 23420) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-11-24 |