| NPI | 1689949448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 65224) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02004294A) |
| 207R00000X Internal Medicine (Licence: CA 20A14186) | |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2019-05-13 |