| NPI | 1922113182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 24370) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 25340) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-05-03 |