| NPI | 1750479283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 216068) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI 10713) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-02-15 |