| NPI | 1679921332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 277601) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267826) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2024-04-19 |