| NPI | 1457892655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101269909) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D89988) |
| 207R00000X Internal Medicine (Licence: ME MD27851) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-05-14 |