| NPI | 1487221917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 100836) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151015222APP21) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2024-12-03 |