| NPI | 1114424454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO195744) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG188395) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2022-10-13 |