| NPI | 1457557613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 7984164-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 81245) |
| 207R00000X Internal Medicine (Licence: IN 01068450A) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2012-08-31 |