| NPI | 1689754822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 42017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301038306) |
| 207R00000X Internal Medicine (Licence: IN 01068145A) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2024-03-13 |