| NPI | 1518372325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 18093) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN20562) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2023-12-07 |