| NPI | 1841285426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01046499A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01046499A) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2025-06-11 |