| NPI | 1689961088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M-16506) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2011019834) |
| 207R00000X Internal Medicine (Licence: IN 01080817A) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2023-10-24 |