| NPI | 1316227143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 58281) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MN 58281) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2020-08-11 |