| NPI | 1043233521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-17067) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R5333) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-01-17 |