| NPI | 1508398074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01088253A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL51139) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-03-24 |