| NPI | 1366674707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 250643) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301093266) |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2021-03-29 |