| NPI | 1558463836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NV 8548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 8548) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2016-10-07 |