| NPI | 1467872911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D88025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 269585) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2024-08-28 |