| NPI | 1508502386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-25328-0) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-8298) |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2025-06-24 |