| NPI | 1922073386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D85980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101224138) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2021-03-25 |