| NPI | 1730824244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01097266A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 11022178A) |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2025-08-13 |