| NPI | 1003236415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A146548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0024035) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2024-01-09 |