| NPI | 1134159163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD MD21481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME69205) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-06-27 |