| NPI | 1093156028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0080707) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301102755) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2019-05-08 |