| NPI | 1992253298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01081869A) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2023-02-23 |