| NPI | 1386751964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01045547A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 223079) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-09-25 |