| NPI | 1942364948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 55489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 246649) |
| 207R00000X Internal Medicine (Licence: PA MT188600) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2022-03-29 |