| NPI | 1033350392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-40317) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 40317) |
| 207R00000X Internal Medicine (Licence: LA MD.203057) | |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2020-08-30 |