| NPI | 1518035468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 068687) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 018163) |
| 207R00000X Internal Medicine (Licence: MI 4301102441) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2021-10-26 |