| NPI | 1750708244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01082938A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 10412) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2019-09-25 |