| NPI | 1255407599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101221468) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE MD17822) |
| 207R00000X Internal Medicine (Licence: MD 00038129) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2021-05-31 |