| NPI | 1982045902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01076343A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103703) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2021-03-22 |