| NPI | 1639457807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01093869A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.136186) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2024-07-01 |