| NPI | 1487620209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS15681) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS006945L) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2025-08-18 |