| NPI | 1023538337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 93430) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101023488) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-11-29 |