| NPI | 1245406636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102204088) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD H071890) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2022-02-23 |