| NPI | 1114556271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 3214) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 93016) |
| 207R00000X Internal Medicine (Licence: GA 93016) | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2024-01-19 |