| NPI | 1437788460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME168563) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 41387) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-10-02 |