| NPI | 1841220431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME 016032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD45673) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2023-03-07 |