| NPI | 1134474091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01075518A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101406) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2020-09-11 |