| NPI | 1992110605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 16012) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 13355) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2015-10-28 |