| NPI | 1508848102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01048446A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01048446) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2021-11-18 |