| NPI | 1760915169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-14629) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-3435) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2023-04-20 |