| NPI | 1922252097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME114441) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI W 320 122 546 711) |
| Enumeration Date | 2008-11-15 |
| Last Update Date | 2024-04-26 |