| NPI | 1093796286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 70026) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME70026) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2021-06-10 |