| NPI | 1588636013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS19288) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 3486) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2022-09-14 |