| NPI | 1689010076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS16476) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R2265) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2020-02-20 |