| NPI | 1396913398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 15762) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT MEDICAL RESIDENT) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2022-11-01 |