| NPI | 1033307376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2022026486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301106085) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2022-10-06 |