| NPI | 1730360587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D70766) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P20661) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2024-05-14 |