| NPI | 1598932915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 52739) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-13759) |
| 207R00000X Internal Medicine (Licence: MS 22215) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2023-01-26 |