| NPI | 1184252355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.46376) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD218127) |
| 207R00000X Internal Medicine (Licence: KS 04-48113) | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2025-03-19 |