| NPI | 1528552031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID O-1866) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID MRO1909) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-09-09 |