| NPI | 1528696598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01090857A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 1528696598) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-03-26 |