| NPI | 1225228836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND 10662) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 202000190) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2024-05-08 |