| NPI | 1801247697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 7233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101022501) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2021-08-23 |