| NPI | 1093246852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301509029) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 520595110) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-06-26 |