| NPI | 1336726645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01093301A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 25445) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-07-16 |