| NPI | 1386219665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO3684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1715) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2024-08-02 |