| NPI | 1952797631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 51861) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 66822) |
| 207R00000X Internal Medicine (Licence: WI 5701) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-11-21 |