| NPI | 1417453432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A185397) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301505391) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-04-18 |