| NPI | 1396782900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 38866) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01059142A) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-02-09 |