| NPI | 1720340193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 54102) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 34836) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2022-01-26 |