| NPI | 1598345704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 99708) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 33847) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2024-09-12 |