| NPI | 1427578608 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 27841)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-13432)  | 
| 207R00000X Internal Medicine (Licence: TN 61585)  | |
| Enumeration Date | 2017-06-20 | 
| Last Update Date | 2021-03-29 |