| NPI | 1235146721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301058752) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301058752) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-06-19 |