| NPI | 1376005850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 30132) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-3775) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-04-29 |