| NPI | 1841511136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2013-01050) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 166016) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2021-12-15 |