| NPI | 1972919603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL PHC 23) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL PHC 23) |
| 207R00000X Internal Medicine (Licence: FL PHC 23) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2018-08-28 |