| NPI | 1679837066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MS 23514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 23514) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2022-04-26 |