| NPI | 1356504856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 510005) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP181) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2024-08-02 |