| NPI | 1316144215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-22640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 27784) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2022-07-15 |