| NPI | 1720068596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD216510) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 17747) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2023-10-27 |