| NPI | 1336466366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 74943) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 38784) |
| 207R00000X Internal Medicine (Licence: GA 074943) | |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2023-12-20 |