| NPI | 1487618567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 14017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 81873) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-11-22 |