NPI | 1972706315 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 11012036A) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IN 11012036A) |
Enumeration Date | 2007-06-05 |
Last Update Date | 2022-01-25 |