| NPI | 1003090143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 235223) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 224760) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2021-03-22 |