| NPI | 1093397754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 71944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 31628) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2024-09-23 |