| NPI | 1528410255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2019-01847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301110552) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2024-02-27 |