| NPI | 1205149036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-42620) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A155553) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2019-12-02 |