| NPI | 1184062309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO2144) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV SL0955) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2025-09-09 |