| NPI | 1417259805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2024036759) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 51841) |
| 207R00000X Internal Medicine (Licence: IN 99102096A) | |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2024-09-16 |