| NPI | 1932140092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 39792) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT 8728) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2022-01-04 |