| NPI | 1457672552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01072700A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 245611) |
| Enumeration Date | 2010-06-13 |
| Last Update Date | 2021-11-29 |