| NPI | 1699878959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02004048A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 44910) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2023-03-07 |