| NPI | 1073734133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 52325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 6295) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2016-02-08 |