| NPI | 1699941443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 56024) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 233116) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2017-03-17 |