| NPI | 1093828253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101248947) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD463398) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2022-11-14 |