| NPI | 1679867071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD171285) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301098725) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2023-07-24 |