| NPI | 1497169163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-19795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD21894) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2021-06-09 |