| NPI | 1194288647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0024879) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP61246170) |
| 207R00000X Internal Medicine (Licence: MD H0105426) | |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2026-02-02 |