| NPI | 1821416108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA fr7433117) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN FR7083948) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2019-03-29 |