| NPI | 1013941590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 109882) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C10007829) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2023-03-09 |