| NPI | 1538247879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 060951) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 309691) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-08-03 |