| NPI | 1922354042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-20283) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101258052) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2021-06-09 |