| NPI | 1881180784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0024012) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA c205981) |
| 207R00000X Internal Medicine (Licence: MD D0102948) | |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2026-05-06 |