| NPI | 1487626883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101-039310) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 28232) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2024-09-04 |