| NPI | 1558820605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD219329) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 292337) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2024-07-24 |