| NPI | 1366730467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01095975A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 03426) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2025-04-16 |