| NPI | 1437596475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0102204053) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204053) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2024-11-21 |