| NPI | 1235105313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 12413) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 223130) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2017-01-17 |