| NPI | 1093001802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO2183) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 2696) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2024-01-11 |