| NPI | 1801386412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01086260A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071800) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2022-01-06 |