| NPI | 1992741862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GU M-905) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GU M00905) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2023-03-26 |