| NPI | 1518932854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL os14015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102036888) |
| 207R00000X Internal Medicine (Licence: AZ 008288) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-04-28 |