| NPI | 1487967816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS016832) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA ot013706) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2024-11-14 |