| NPI | 1417305434 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-17952)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022026880)  | 
| 207R00000X Internal Medicine (Licence: IN 01082369A)  | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 0003650493)  | |
| Enumeration Date | 2016-05-31 | 
| Last Update Date | 2025-07-14 |