| NPI | 1295229276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 64266) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018021684) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2021-09-28 |