| NPI | 1518298918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1020357) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI md13689) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2024-07-11 |