| NPI | 1528379609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2016-01426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL32919) |
| 207R00000X Internal Medicine (Licence: SC 32919) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2023-08-02 |