| NPI | 1740401710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101245166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 0430668) |
| 207R00000X Internal Medicine (Licence: AK 5329) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-06-22 |