| NPI | 1477042687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS023762) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS18545) |
| 208D00000X General Practice (Licence: FL OS18545) | |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2024-05-31 |