| NPI | 1851969729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-50975) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-12247) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2024-08-07 |