| NPI | 1447879952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO216216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR 199544) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2023-07-26 |