| NPI | 1922161736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 1204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A8968) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-06-23 |