| NPI | 1588224679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 8599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01093893A) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2024-06-07 |