| NPI | 1346440989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01075004A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301078786) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2024-02-16 |