| NPI | 1033603758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1016620) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301504375) |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2024-01-07 |