| NPI | 1669705083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS11671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS511671) |
| 207R00000X Internal Medicine (Licence: FL UO2209) | |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2024-12-24 |