| NPI | 1700033727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01072529A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092338) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2022-10-03 |