| NPI | 1740430545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AK 4933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 67320) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2024-02-02 |