| NPI | 1275777963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101255065) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0074313) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2023-11-27 |