| NPI | 1902428212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 7948) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10071313) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2023-08-16 |