| NPI | 1699906321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01068542A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 43001089743) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2021-02-03 |