| NPI | 1073806071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-37935) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2016007049) |
| 207R00000X Internal Medicine (Licence: MI 4301098297) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2018-04-05 |