| NPI | 1942643952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL TRN) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01081228A) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2018-10-10 |