| NPI | 1245866185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID O-1930) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02007219A) |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2024-04-29 |