| NPI | 1033340161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 172414) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 51747) |
| 207R00000X Internal Medicine (Licence: MT 52004) | |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2022-02-28 |