| NPI | 1013011303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 321454) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 321454) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: LA 321454) | |
| 208D00000X General Practice (Licence: MS 12640) | |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2023-05-03 |