| NPI | 1689068652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO186918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG172374) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2020-03-30 |