| NPI | 1750607933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 47318) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101246485) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2023-02-27 |