| NPI | 1902330350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D88996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01090773A) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2023-09-26 |