| NPI | 1013545672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1013046) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.077179) |
| 207R00000X Internal Medicine (Licence: IL 036.161707) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2023-06-18 |