| NPI | 1952510034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 146537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301087589) |
| 207R00000X Internal Medicine (Licence: IA 40605) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-03-18 |