| NPI | 1831502392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 260471) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0026556) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2023-11-21 |