| NPI | 1174937726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM A-2486-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 1490) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2024-10-18 |