| NPI | 1760529648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0050605) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0050605) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-07-21 |