| NPI | 1861481574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-21457) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 10541) |
| 207R00000X Internal Medicine (Licence: UT 6069563-1205) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2021-06-09 |