| NPI | 1508175530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS12102) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO2460) |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2022-05-25 |