| NPI | 1326288697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS 10859) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017928) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2022-02-01 |