| NPI | 1144808288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS21233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102209086) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2025-07-15 |