| NPI | 1659756476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS 13528) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL OS13528) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2024-01-02 |