| NPI | 1437853033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 77557) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 33352) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2024-08-09 |