| NPI | 1437560620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO3048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 56723) |
| Enumeration Date | 2014-05-10 |
| Last Update Date | 2022-01-27 |