| NPI | 1679650428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ACN845) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 14204) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-11-19 |