| NPI | 1720349061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 60630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 27593) |
| 207R00000X Internal Medicine (Licence: AR E-13672) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2024-03-22 |