| NPI | 1457484982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 15186) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 49418) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2023-01-20 |