| NPI | 1114548484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-51300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R78073) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2023-06-14 |