| NPI | 1033434576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2020012718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-01889) |
| Enumeration Date | 2010-03-27 |
| Last Update Date | 2024-02-12 |