| NPI | 1508845876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 58508) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-29083) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-02-08 |