| NPI | 1841588837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS11940) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL OS11940) |
| 261QP2300X Clinic/Center, Primary Care (Licence: FL OS11940) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: FL OS11940) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2025-12-06 |