| NPI | 1154874881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01087707A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7777) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2022-06-21 |