| NPI | 1326483009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS13046) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3321) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2019-07-15 |