| NPI | 1396842803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD016617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 16617) |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2021-09-15 |