| NPI | 1215252432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 153618) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.205521) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2024-02-16 |