| NPI | 1588697668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101058320) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101058320) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2024-05-02 |