| NPI | 1780243089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-22684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-7737) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2022-07-22 |