| NPI | 1407236607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101021696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 90368) |
| 207R00000X Internal Medicine (Licence: TN 4569) | |
| 207R00000X Internal Medicine (Licence: AL DO.2760) | |
| 207R00000X Internal Medicine (Licence: FL TPOS246) | |
| 207R00000X Internal Medicine (Licence: TX S8512) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2022-07-09 |