| NPI | 1134797327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0029438) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0100669) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2026-04-08 |