| NPI | 1649363656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 12991) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 19945) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-05-09 |