| NPI | 1871780874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 21169) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT190232) |
| 207R00000X Internal Medicine (Licence: AR E-12044) | |
| 207R00000X Internal Medicine (Licence: TN 49719) | |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2022-05-11 |