| NPI | 1386437226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 83097) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 35370) |
| Enumeration Date | 2025-05-23 |
| Last Update Date | 2026-07-13 |