| NPI | 1598192650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01076851A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.063780) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2021-03-05 |