| NPI | 1952742991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 24505) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 65992) |
| 207R00000X Internal Medicine (Licence: AR E-13960) | |
| Enumeration Date | 2013-07-06 |
| Last Update Date | 2023-06-07 |