| NPI | 1548491673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 22167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 49066) |
| 207R00000X Internal Medicine (Licence: AR E-12840) | |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2020-08-18 |