| NPI | 1407593205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-25643) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-8315) |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2025-09-09 |