| NPI | 1538210737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2017-02610) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS MS18384) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2021-03-25 |