| NPI | 1982808275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01066589A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 48905) |
| 208000000X Pediatrics (Licence: IN 01066589A) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2022-11-10 |