| NPI | 1306403795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-49828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11514) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2022-07-13 |