| NPI | 1447591714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS17434) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS017841) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2021-08-17 |