| NPI | 1790949956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-18353) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 235414) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2019-03-19 |