| NPI | 1962470625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01031165A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 15431) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2018-09-27 |