| NPI | 1831327964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 74015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 54837) |
| 207R00000X Internal Medicine (Licence: IL 4139893) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2023-08-01 |