| NPI | 1639688286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH EL31855) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS16952) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2024-11-06 |