| NPI | 1750802849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.069795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01097570A) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2025-09-24 |