| NPI | 1922392794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI DOS-1703) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 258178) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2016-08-03 |