| NPI | 1568447886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101043453) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101-043453) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2025-08-15 |