| NPI | 1881073625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 57704) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 326407) |
| 207R00000X Internal Medicine (Licence: AR E-13223) | |
| 207R00000X Internal Medicine (Licence: MS 27701) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2024-01-04 |