| NPI | 1982131355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01083993A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301500546) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2024-01-02 |