| NPI | 1013581743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 010982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1716) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-08-14 |