| NPI | 1326401787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A178812) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101266346) |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2023-10-08 |