| NPI | 1851902241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4351046540) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01089188A) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2023-07-27 |