| NPI | 1083866339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 58293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND PT11962) |
| 207R00000X Internal Medicine (Licence: ND 11962) | |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2024-07-29 |