| NPI | 1306370051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 4357) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R4456) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2023-10-19 |