| NPI | 1013921162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 00012041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD12041) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2022-07-21 |