| NPI | 1447607627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 70118) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-42260) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2026-07-01 |