| NPI | 1447420310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01064019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 68336) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2022-10-14 |