| NPI | 1588291223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1014060) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 284532) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2023-07-10 |