| NPI | 1285077701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID O-1432) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV DO2117) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2023-10-09 |