| NPI | 1831160977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME95005) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 053819) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2026-02-23 |