| NPI | 1588690424 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 9353) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 9353) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2024-06-03 |