| NPI | 1598211252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2019-0056) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7833) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2024-07-31 |