| NPI | 1093455768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0028481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0104400) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2025-10-03 |