| NPI | 1144201914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 05-41936) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 101192) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2026-01-26 |