| NPI | 1396908430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 2317) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102202866) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2020-05-02 |