| NPI | 1285096800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02007940A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS16196) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-09-27 |