| NPI | 1881865103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL DO990) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL DO.990) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2023-02-02 |