| NPI | 1659339083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD26911) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 47999) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-11-06 |