| NPI | 1801962931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN MN 45974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 45974) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-02-12 |