| NPI | 1326087867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 21146) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD417290) |
| 207R00000X Internal Medicine (Licence: UT 45536241205) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-11-27 |