| NPI | 1518595487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.163500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.075906) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2023-06-19 |