| NPI | 1497138499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A184725) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P31342) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2023-05-25 |