| NPI | 1275627077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 19565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC MD19565) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-04-22 |