| NPI | 1093768400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0072112) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0072112) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-03-16 |