| NPI | 1881651636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01053794A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01053794A) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2021-01-26 |