| NPI | 1801153705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 24049) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 53158) |
| 207R00000X Internal Medicine (Licence: AR E-13350) | |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2020-08-18 |