| NPI | 1093930513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2018-0732) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-33075) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-02-16 |