| NPI | 1013983196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2023-1656) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 33041) |
| 207R00000X Internal Medicine (Licence: IL 036164434) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2024-04-26 |