| NPI | 1538110457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 15095) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD 14336) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2022-10-21 |