| NPI | 1992985949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 47622) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA pgy.1.tul-im) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2012-05-02 |