| NPI | 1952985467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0099578) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME168448) |
| 207R00000X Internal Medicine (Licence: VA 0101282983) | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2024-07-08 |