| NPI | 1427543578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101026205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101023982) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2022-11-17 |