| NPI | 1942521836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 2944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204288) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2025-02-18 |