| NPI | 1689104408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-21035) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-7265) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2021-06-11 |