| NPI | 1891352803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A177014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351045007) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2023-04-26 |