| NPI | 1346560406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 56402) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 245061) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2021-10-18 |