| NPI | 1588152607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 40229) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-46674) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MO 2021026162) | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2023-09-08 |