| NPI | 1548228497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 315992-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 17627) |
| 207R00000X Internal Medicine (Licence: ND 14541) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2024-03-28 |