| NPI | 1457883985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2024032651) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301501883) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2024-10-07 |