| NPI | 1992740260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 106911) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-12463) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2021-12-13 |