| NPI | 1427021955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 38271) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 70486) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2024-04-23 |