| NPI | 1538137633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VI 2022) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-1074) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2026-07-28 |