| NPI | 1043298524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 048495) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME150223) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2024-07-10 |