| NPI | 1942262829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 38109) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 18404) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2023-02-28 |