| NPI | 1699099663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 54844) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS44080) |
| 208000000X Pediatrics (Licence: TN MD54844) | |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2022-03-29 |