| NPI | 1891992640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 19831) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-1834) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2014-09-23 |