| NPI | 1205148491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS11917) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO2528) |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2024-04-22 |