| NPI | 1831728377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 96085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101282419) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-07-22 |