| NPI | 1356086250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR PG211595) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A23979) |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2025-08-29 |