| NPI | 1932588407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 26703) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-13921) |
| 207R00000X Internal Medicine (Licence: TN 3718) | |
| 207R00000X Internal Medicine (Licence: FL OS15264) | |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2021-03-12 |