| NPI | 1578754040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01074887A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301084917) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2022-11-11 |