| NPI | 1477815777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-22579) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME124896) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2022-07-29 |