| NPI | 1700179249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC MMD.37384 MD) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 37384) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2024-06-04 |