| NPI | 1346737269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-13909) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10064050) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2021-06-15 |