| NPI | 1760741789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 59141) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 24498) |
| 207R00000X Internal Medicine (Licence: AR E-14097) | |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2024-03-21 |