| NPI | 1568548790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01076261a) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 19536) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2024-05-10 |