| NPI | 1326781865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 011686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02008395A) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2025-06-19 |