| NPI | 1720025174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01038703A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01038703A) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2016-11-23 |