| NPI | 1356318810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 16163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 026617) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2022-05-26 |