| NPI | 1447406079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2016-00541) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC TL35137) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2024-03-18 |