| NPI | 1962476077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202D00000X Integrative Medicine (Licence: NC 2024-00797) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2024-00797) |
| 207R00000X Internal Medicine (Licence: MO 2019005174) | |
| 207R00000X Internal Medicine (Licence: IL 036.156348) | |
| 207R00000X Internal Medicine (Licence: VA 0101047305) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2024-08-30 |