| NPI | 1598743668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 87-182) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301046971) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2022-08-18 |