| NPI | 1093083669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 207040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL L.3562R) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2024-11-05 |