| NPI | 1154409175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 1154409175) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 49841) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2025-08-28 |