| NPI | 1811144678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 44822) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125054418) |
| 207R00000X Internal Medicine (Licence: IN 01073880A) | |
| Enumeration Date | 2008-08-24 |
| Last Update Date | 2023-02-06 |