| NPI | 1851688436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 23277) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-2433) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2015-08-11 |