| NPI | 1427144179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301064311) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 4243) |
| 207R00000X Internal Medicine (Licence: MT 10753) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-06-19 |