| NPI | 1992977847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2022-03336) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 66138) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2023-10-11 |