| NPI | 1710979695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-17813) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0043623) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2024-05-03 |