| NPI | 1770514408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 7575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME96214) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-10-24 |