| NPI | 1316589799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NM MD2019-0456) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2019-0456) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |