| NPI | 1437641537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA DO-05773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11258) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2021-04-01 |