| NPI | 1093278434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 66550) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R77318) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2025-03-11 |