| NPI | 1851317192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2009-0047) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301056000) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2024-01-17 |