| NPI | 1386706885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101242154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0092208) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2024-06-03 |