| NPI | 1477531887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR 53225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 40572) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2021-12-08 |