| NPI | 1881071124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2023005511) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-47208) |
| 207R00000X Internal Medicine (Licence: OR MD195200) | |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2023-02-21 |