| NPI | 1477505063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 65886-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 65886-21) |
| 207Q00000X Family Medicine (Licence: IN 02002249A) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2024-04-18 |