| NPI | 1952747883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02006312A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101020390) |
| Enumeration Date | 2013-05-19 |
| Last Update Date | 2023-05-23 |