| NPI | 1609859289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL BF8198788) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301502279) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2022-09-27 |