| NPI | 1740257328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2009-02028) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 44384) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2024-03-18 |