| NPI | 1265438105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME108080) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01046796A) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-11-16 |