| NPI | 1265645782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: AZ 56163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M7625) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-10-31 |