| NPI | 1730564246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01081199A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.066493) |
| Enumeration Date | 2015-07-26 |
| Last Update Date | 2021-02-09 |