| NPI | 1669791570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD157672) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG151638) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2021-07-01 |