| NPI | 1154806610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MD D0098824) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0098824) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2023-11-06 |