| NPI | 1497250203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 65924) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29204) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2020-08-25 |