| NPI | 1851812572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02005976A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125071534) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-07-21 |