| NPI | 1316475197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2024-03350) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271081) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2024-11-25 |