| NPI | 1922666171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-16793) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL82197) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2023-07-25 |