| NPI | 1619970340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01027487A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01027487) |
| Enumeration Date | 2005-05-26 |
| Last Update Date | 2010-07-13 |