| NPI | 1497173546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 22290) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME128823) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2022-04-27 |