| NPI | 1194107987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 18877) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264334) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2024-10-11 |