| NPI | 1851672844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS11997) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO2926) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2018-03-26 |