| NPI | 1487182424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 66392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD199709) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2023-03-22 |