| NPI | 1629483110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 25115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-13407) |
| 207R00000X Internal Medicine (Licence: TN 61824) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2020-08-19 |