| NPI | 1043692197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD H96459) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 05-40745) |
| 207R00000X Internal Medicine (Licence: MO 2015017143) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2023-12-29 |