| NPI | 1295319465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301511992) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351047780) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2024-05-08 |