| NPI | 1265840805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0012535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0104272) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2025-10-23 |