| NPI | 1851705396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A144328) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 56673) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2024-11-14 |