| NPI | 1306333414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 34007) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OK 34007) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2026-05-07 |