| NPI | 1346249109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 34829) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 034829) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2024-01-30 |