| NPI | 1992018485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 46136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI L1838063) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2023-11-27 |