| NPI | 1902072077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.22433) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-3836) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2024-05-20 |