| NPI | 1073927984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-44491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-10102) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2017-10-13 |