| NPI | 1265835854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS14004) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3513) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2016-08-03 |