| NPI | 1831165877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS0093331L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA OS-009331L) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-07-06 |