| NPI | 1326533431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD0000065428) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T3500) |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2023-04-08 |