| NPI | 1427031194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 24049) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 70685) |
| Enumeration Date | 2005-11-27 |
| Last Update Date | 2022-04-19 |