| NPI | 1598771677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AR 621705355) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-1343) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2015-11-09 |