| NPI | 1437114998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 21538) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01033400A) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-04-14 |