| NPI | 1013323187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 67684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-10126) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2024-02-16 |