| NPI | 1801997390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 34337) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD24554) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2018-12-14 |