| NPI | 1649690769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: AZ 008152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 1649690769) |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: FL 1649690769) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2025-02-11 |