| NPI | 1942575725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 21913) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301106748) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2024-03-15 |