| NPI | 1720063951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01049923A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01049923A) |
| 208D00000X General Practice (Licence: IN 01049923A) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2021-02-12 |