| NPI | 1871838052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS13262) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO 3340) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2018-03-17 |