| NPI | 1689000697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD H0083880) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 5763) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2018-09-04 |