| NPI | 1366899585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 18534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN23397) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2021-02-23 |