| NPI | 1477139012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01094057A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 11022020A) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2025-10-13 |