| NPI | 1013379130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D88936) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0012714) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-08-12 |