| NPI | 1558651919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 24679) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-12373) |
| 207R00000X Internal Medicine (Licence: TN 51416) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2020-11-24 |