| NPI | 1346242427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 14122) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 14122) |
| 207R00000X Internal Medicine (Licence: AZ an14122) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2022-07-29 |