| NPI | 1598966442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101251116) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0089715) |
| 207R00000X Internal Medicine (Licence: TN 48663) | |
| 207R00000X Internal Medicine (Licence: HI MD-14644) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: VA 0101251116) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2023-03-07 |