| NPI | 1992783260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102207534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS10819) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2023-01-05 |