| NPI | 1649241894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2001-00156) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200100156) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-09-28 |