| NPI | 1972741338 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IN 01064273A) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01064273A) | 
| Enumeration Date | 2009-01-22 | 
| Last Update Date | 2020-12-17 |