| NPI | 1891954889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC TL30587) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 30587) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2024-11-01 |