| NPI | 1093820334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME76646) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 76646) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-09-05 |