| NPI | 1124408885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A156005) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R75124) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2024-06-10 |