| NPI | 1164839775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A172371) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0012035) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2024-05-16 |