| NPI | 1669461042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME61788) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200500847) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2024-02-20 |