| NPI | 1043955131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0028089) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0104560) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2025-09-15 |