| NPI | 1740420041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 14079) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R70455) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2020-12-30 |