| NPI | 1497105373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 59435) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL39872) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2023-04-13 |