| NPI | 1972595726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01048941A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01048941A) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2023-05-30 |