| NPI | 1629381637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 86848) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101257874) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2023-10-31 |