| NPI | 1538425558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 51955) |
| Additional Taxonomies | 202K00000X (Licence: AZ 51955) |
| 207R00000X Internal Medicine (Licence: NM md2015-0691) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2024-11-03 |