| NPI | 1952621856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 21446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 243858) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2021-05-12 |