| NPI | 1982139119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0088778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0027491) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2025-02-19 |