| NPI | 1285131912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC DO83385) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 201901946) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2021-07-07 |