| NPI | 1336300383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AK 8263) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD039860) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2023-03-22 |