| NPI | 1669906632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO2734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-13280) |
| 207R00000X Internal Medicine (Licence: AR C19-0022) | |
| 207R00000X Internal Medicine (Licence: CA 20A16883) | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2020-10-02 |