| NPI | 1265444020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2018-02012) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 034252) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2024-08-06 |