| NPI | 1750591053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2006025332) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID O-1735) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-09-20 |