| NPI | 1356909311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-15657) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 250254) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2025-05-19 |