| NPI | 1417453648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01087522A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01087522A) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2026-05-18 |