| NPI | 1093989618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A126186) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 11013050) |
| 207R00000X Internal Medicine (Licence: NV 13124) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2023-12-08 |