| NPI | 1033904826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 83044) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 35192) |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2026-07-14 |