| NPI | 1477906972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 24958) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0100417) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2024-12-23 |