| NPI | 1740227693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2006006317) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-31715) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2023-08-08 |