| NPI | 1467710848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 074186) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-02563) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2024-05-06 |