| NPI | 1750886990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 46942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME149929) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2026-05-04 |