| NPI | 1700177482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 57897) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 27220) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2024-03-22 |