| NPI | 1487155099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS20914) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS021253) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2025-11-25 |