| NPI | 1033183298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102204429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR DO162266) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-07-02 |