| NPI | 1649408808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 4189) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R8668) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2023-11-06 |