| NPI | 1770018384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2020-0342) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R76077) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2024-01-22 |