| NPI | 1881200368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2022-1563) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.075432) |
| Enumeration Date | 2020-09-19 |
| Last Update Date | 2023-08-02 |