| NPI | 1649432733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 65929) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS17194) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2024-12-30 |