| NPI | 1487181079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1019656) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-44998) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2024-10-31 |