| NPI | 1396107751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-11969) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 32754) |
| 207R00000X Internal Medicine (Licence: TN 4623) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2026-10-06 |