| NPI | 1326071960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D92773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR 22177) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-10-05 |