| NPI | 1003349242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: AZ 64715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R76009) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: AZ R76009) | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2022-06-27 |