| NPI | 1356496178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101051234) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D30907) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2024-05-07 |