| NPI | 1619131299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 61310) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 061310) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2023-03-07 |