| NPI | 1124132188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 9-320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01039588) |
| 207R00000X Internal Medicine (Licence: IA 40674) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2022-07-21 |