| NPI | 1598291346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 23066) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020021400) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2022-10-21 |