| NPI | 1083147516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D88979) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN D88979) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2022-01-11 |