| NPI | 1538127402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A61886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0057896) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-02-03 |