| NPI | 1306096938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2015-00011) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101250357) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2024-02-12 |