| NPI | 1831231299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS13944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS009875L) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2019-09-06 |