| NPI | 1346506540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01074979A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 51778) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2016-10-14 |