| NPI | 1265844112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0012021) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4017) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2017-07-07 |