| NPI | 1629072111 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01039120A)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01039120A)  | 
| Enumeration Date | 2005-06-13 | 
| Last Update Date | 2015-05-26 |