| NPI | 1598260465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 22529) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29305) |
| 207R00000X Internal Medicine (Licence: MA 286328) | |
| 207R00000X Internal Medicine (Licence: MN 65898) | |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2022-06-22 |