| NPI | 1568443273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 74119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 00007119) |
| 207R00000X Internal Medicine (Licence: ME EL191035) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2024-06-25 |