| NPI | 1750523544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 21975) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-14335) |
| 207R00000X Internal Medicine (Licence: TN 64434) | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2022-09-01 |