| NPI | 1821074592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR C4596) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR C4596) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: AR C4596) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: AR C4596) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AR C4596) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AR C4596) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2018-03-23 |