| NPI | 1942563820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 88236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01074906) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2024-04-09 |