| NPI | 1063477529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0003983) |
| Additional Taxonomies | 208600000X Surgery (Licence: DE C1-0003983) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2024-06-06 |