| NPI | 1548780125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.070291) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01083209A) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2023-10-04 |