| NPI | 1194349522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-50307) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11828) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2023-07-05 |