| NPI | 1477523371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 032173) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 83860) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2020-12-22 |