| NPI | 1437643467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 88788) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL52841) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2022-01-18 |