| NPI | 1659312759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01046233C) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01046233A) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2019-07-19 |