| NPI | 1487722914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301049092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 49092) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2022-02-07 |