| NPI | 1205406154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS21250) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-4237) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2024-08-09 |