| NPI | 1932549987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 268970) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103898) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2020-04-21 |