| NPI | 1841225406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD0000021556) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 021556) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-07-21 |