| NPI | 1265695282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD434836) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0011112) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2025-03-05 |