| NPI | 1942393327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 53528) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 053528) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2022-03-08 |