| NPI | 1548271208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 33907) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 8411) |
| 207R00000X Internal Medicine (Licence: CA C36042) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2023-05-12 |