| NPI | 1548528375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2017-01342) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 183325) |
| 207R00000X Internal Medicine (Licence: HI MD-18082) | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2024-04-19 |