| NPI | 1225008501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 18194) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301068622) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2026-05-20 |