| NPI | 1184988131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0087658) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0011428) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2024-09-24 |