| NPI | 1154434637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 44362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R7917) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-04-06 |