| NPI | 1437770567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS19650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP05397) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2023-10-26 |