| NPI | 1033211479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD011298) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.011298) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2023-11-09 |