| NPI | 1093209611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01085637A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301114549) |
| 207R00000X Internal Medicine (Licence: MI 4351034764) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2022-10-15 |