| NPI | 1326006511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO MDR2P98) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R2P98) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2023-12-22 |