| NPI | 1184883993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA md439394) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0009410) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2019-12-12 |