| NPI | 1376506337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 50942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 19047) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2019-07-15 |