| NPI | 1619980901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C199437) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI KZ063288) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2026-07-28 |