| NPI | 1700614906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 11024228A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 11024228A) |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2025-06-23 |