| NPI | 1215974894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0012226) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D83821) |
| 207R00000X Internal Medicine (Licence: VA 0101233779) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-07-21 |