| NPI | 1043397276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 9085) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 9085) |
| 208D00000X General Practice (Licence: AZ 9085) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-12-05 |