| NPI | 1023266038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101253031) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2013-0059) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2023-02-24 |