| NPI | 1215169321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 5607) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 005918) |
| Enumeration Date | 2009-08-23 |
| Last Update Date | 2017-02-23 |