| NPI | 1346261260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01030686A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M-10722) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2017-03-02 |