| NPI | 1225055213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND 8689) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 1034) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2022-03-25 |