| NPI | 1851749055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 007769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101022388) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2023-07-03 |