| NPI | 1417698184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101028021) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151015605) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-06-13 |