| NPI | 1073523148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 021568) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 021568) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-10-24 |