| NPI | 1033499306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 57429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 107265) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2022-12-20 |