| NPI | 1386908374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0079274) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 435407ZDNA) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2023-01-18 |