| NPI | 1992379531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO3644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1722) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2024-06-24 |