| NPI | 1245694751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 29346) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 61526) |
| 207R00000X Internal Medicine (Licence: AR E-14734) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2021-10-15 |