| NPI | 1871731133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2010031553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 05-42006) |
| Enumeration Date | 2009-01-25 |
| Last Update Date | 2024-07-11 |