| NPI | 1235624248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101025867) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151010536) |
| 207R00000X Internal Medicine (Licence: MI 5101024212) | |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2023-10-12 |