| NPI | 1861951972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 70593) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 70593) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TN 70593) | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2024-07-13 |