| NPI | 1932336617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 066751) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 066751) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2021-09-16 |