| NPI | 1871007344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101275642) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 273598) |
| 207R00000X Internal Medicine (Licence: IN 01085066A) | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2023-06-22 |