| NPI | 1184858029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 5292302-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M-11677) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2024-05-23 |