| NPI | 1700992674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101265722) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01070720A) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2024-01-17 |