| NPI | 1003860172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI 5801) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI 05801) |
| Enumeration Date | 2006-05-21 |
| Last Update Date | 2024-09-20 |