| NPI | 1922263938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 44166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R71140) |
| 207R00000X Internal Medicine (Licence: ID MC-0220) | |
| Enumeration Date | 2008-07-20 |
| Last Update Date | 2022-03-07 |