| NPI | 1255026639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MDR-8494) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-8494-0) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-10 |