| NPI | 1275941148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD d94141) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT 70063) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2022-08-31 |