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 |