| NPI | 1144653494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2024-01533) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 82655) |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2024-12-06 |