| NPI | 1013585397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-18087) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2021019577) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2024-09-24 |