| NPI | 1336142629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 36079980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 29676) |
| 207R00000X Internal Medicine (Licence: TN 35050) | |
| 207R00000X Internal Medicine (Licence: VA 0101230731) | |
| 207R00000X Internal Medicine (Licence: GA 66239) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2021-04-01 |