| NPI | 1952665655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 25900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD52705) |
| 207R00000X Internal Medicine (Licence: AR E-13339) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2020-08-12 |