| NPI | 1598949687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 063642) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 002864) |
| 207R00000X Internal Medicine (Licence: PA MD460014) | |
| Enumeration Date | 2007-12-25 |
| Last Update Date | 2023-07-03 |