| NPI | 1508817719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR 0E2536) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD0000034563) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2024-03-22 |