| NPI | 1083683833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 13450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 000317) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2022-01-27 |