| NPI | 1285897553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 47231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-12764) |
| 207R00000X Internal Medicine (Licence: MS 23275) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2020-08-18 |