| NPI | 1932669330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0024133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN DO0000004725) |
| 207R00000X Internal Medicine (Licence: TX T4142) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-09-16 |