| NPI | 1194769513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD218730) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 19950) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-02-29 |