| NPI | 1013658202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 84330-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 100190-851) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-08-28 |