| NPI | 1043229438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 41861) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 2958) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-07-10 |