| NPI | 1447094974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2024040076) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2024021447) |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2024-10-09 |