| NPI | 1922481837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS15010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4641) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2022-08-12 |