| NPI | 1295806750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2023-02528) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R3P79) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2024-07-18 |