| NPI | 1336551555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD179851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG168174) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2020-10-20 |