| NPI | 1689664070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD478613) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01039400A) |
| 207R00000X Internal Medicine (Licence: MI 4301046691) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2025-01-21 |