| NPI | 1003944406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: DE C2-0008798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE c7-0003472) |
| 208000000X Pediatrics (Licence: DE c7-0003472) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2015-01-05 |