| NPI | 1356558357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 21508) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT011624) |
| 207R00000X Internal Medicine (Licence: TN 2242) | |
| 207R00000X Internal Medicine (Licence: AR E-16069) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2023-01-30 |