| NPI | 1427535020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 75868) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 6105) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2022-06-06 |