| NPI | 1366763351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-16993) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD192600) |
| 207R00000X Internal Medicine (Licence: HI 16993) | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2021-06-09 |