| NPI | 1942410212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M-10488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A053167) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-03-14 |