| NPI | 1487742896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01070169A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 19490) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-12-13 |