| NPI | 1356690002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 2876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-2597) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2025-10-30 |