| NPI | 1578519534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS8797) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 99623) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-08-08 |