| NPI | 1013447549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS16650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO5414) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2024-06-05 |