| NPI | 1952444754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.024281) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 17573) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2023-02-02 |