| NPI | 1437520301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301108712) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY C1031) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2025-04-07 |