| NPI | 1245386846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 16129) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 46371) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2023-11-27 |