| NPI | 1457744005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 5483) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102205239) |
| 207R00000X Internal Medicine (Licence: MN 71129) | |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2024-09-23 |