| NPI | 1821106386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 056277) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2013-00788) |
| Enumeration Date | 2006-08-26 |
| Last Update Date | 2020-01-14 |