| NPI | 1881858686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 66725) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL AL30322) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2020-08-05 |