| NPI | 1811013857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 20A14018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.117482) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2025-12-26 |