| NPI | 1760683262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01066848A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01066848A) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2025-03-08 |