| NPI | 1467795930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 40864) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 00000) |
| 207R00000X Internal Medicine (Licence: IL 036135047) | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2024-08-16 |