| NPI | 1649458712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01071215A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036120262) |
| 207R00000X Internal Medicine (Licence: IL 036.120262) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2025-10-17 |